University of Toronto Pain Medicine Residency accepts its first two residents

On July 1, 2016, after almost a decade of planning, The University of Toronto will start training two residents in the subspecialty of Pain Medicine. According to Dr. John Hanlon, the inaugural Program Director of the Pain Medicine Residency, the milestone represents of over a decade of work by dozens of individuals and is indicative of a paradigm shift in the provision of safe and effective pain medicine to the millions of Canadians who suffer from chronic pain.

This process started in 2007 when the preliminary application for such subspecialty was submitted to the Royal College. In the ensuing years, national support from the parent specialty of anesthesia was secured, the overwhelming societal need was confirmed and evidence that the proposed new discipline had a unique body of knowledge and scope of practice was accepted. In 2010, pain medicine was formally recognized as a subspecialty in Canada by the Royal College of Physicians and Surgeons of Canada. Since that time various stakeholders and team champions have worked tirelessly to develop the standards of training for the subspecialty which inform the curriculum and objectives of training.

Now a reality, this new two-year subspecialty residency will offer unparalleled learning opportunities leading to RCPSC certification in pain medicine. Eligibility requirements include FRCPC certification (or in a program leading to certification) in the following areas: anesthesiology, emergency medicine, internal medicine, neurology, pediatrics, physical medicine and rehabilitation, psychiatry and rheumatology. Dr. Hanlon notes that "here at the University of Toronto, it has truly been a multidisciplinary effort with engagement from stakeholders in each of the eligible specialties that have worked tirelessly to make this multidisciplinary residency a reality."

In the fall of 2015, a total of nine applicants from four different specialties applied for the two pain medicine residency positions available in Toronto.  A seven-member multidisciplinary application sub-committee reviewed the files and interviewed the candidates.  “We are proud to report that we were successful in recruiting top two candidates, a fifth-year Anesthesiology resident named Ehtesham Baig and fifth-year Physical Medicine and Rehabilitation resident named Najam Mian” says Dr Hanlon.

The long-term goal is to offer the Pain Medicine Residency at up to 12 or 13 Universities across the country. As of July 2016, In addition to the University of Toronto, the University of Ottawa, University of British Columbia, Université  de Montréal and Western University will each have either one or two residents for a total of seven pain medicine residents nationally. While Dr. Hanlon feels that there is still a long way to go, the creation of pain medicine as a new subspecialty should not only improve patient access to pain management by increasing the number of well-trained physicians, but also improve patient outcomes by promoting and disseminating best practice guidelines for the treatment of acute pain, chronic noncancer pain and cancer pain in both community and academic settings. In addition, interdisciplinary research collaboration will promote new areas of inquiry and hopefully funding bodies will identify pain as a higher research priority.